Telogen Effluvium and Anesthesia Considerations: A Case Report

Telogen effluvium is a form of non-scarring hair loss characterized by premature shedding of hair. Pathophysiologically, telogen effluvium occurs when a significant number of hair follicles prematurely enter the telogen phase, resulting in excessive shedding. The exact mechanism is unclear, but it is believed to involve alterations in the hair follicle's growth cycle, possibly mediated by illness, infection, major surgery, low protein intake, or hormonal changes. Some medications can also be linked to this disease, such as beta blockers, carbamazepine, and vitamin A. When affected hairs are in the resting phase, noticeable hair shedding occurs. Our patient was a 61-year-old female with a history of telogen effluvium, and exacerbations occurred after surgery. She presented for a reduction and internal fixation of her left tibia and left lateral meniscus repair after a fall. She was very concerned about the possibility of undergoing surgery, as recent exacerbations had caused significant hair loss over several months. There are no guidelines on anesthesia considerations for patients with this rare disorder. This case report hopes to shed light on techniques to reduce exacerbations in these patients.